Effect of cost education, cost audits, and faculty chart review on the use of laboratory services

A randomized controlled trial of several strategies designed to reduce the use of laboratory tests by house staff was performed in two parts. Part 1 compared cost education, cost audits, and both methods combined, all after a baseline observation period. Significant reductions were achieved only in the combination group for the categories of total tests (9.4%) and Sequential Multiple Analysis (SMA)-12 (10.8%), but not for charges, SMA-6, or complete blood cell counts (CBCs). Part 2 compared a group subjected to faculty chart review with a control group. Significant reductions in total charges (9.8%), total tests (15.1%), SMA-12s (20.6%), SMA-6s (12.5%), and CBCs (18.5%) were observed in the intervention group, as compared with the control group. Among the methods examined, faculty chart review seems to be the most effective method of reducing the amount of laboratory testing performed by house staff.